| NPI | 1104311760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2023-09-01 |